====== 💊 Donafenib ======

Donafenib is an oral multikinase inhibitor developed as a targeted therapy for hepatocellular carcinoma (HCC) and other malignancies. It is a structural derivative of sorafenib, modified to improve tolerability and pharmacokinetic properties.

🔬 Mechanism of Action
Donafenib inhibits multiple kinases involved in:

Tumor cell proliferation (e.g., RAF/MEK/ERK pathway)

Angiogenesis (e.g., VEGFR, PDGFR)

Tumor microenvironment signaling

By blocking these pathways, it reduces both tumor growth and the formation of new blood vessels supplying the tumor.

📈 Clinical Use
Indication: Approved in China for unresectable or advanced hepatocellular carcinoma (HCC)

Comparison: Shown in clinical trials (e.g., ZGDH3 study) to offer non-inferior survival to sorafenib with fewer adverse events

Typical Role: Used as first-line systemic therapy in HCC, especially when tolerability is a concern

⚠️ Adverse Effects
Hypertension

Hand-foot skin reaction (less frequent than sorafenib)

Diarrhea

Fatigue

Hepatotoxicity (monitor liver function)

📌 Regulatory Status
China: Approved since 2021

Other countries: Not yet widely approved or used outside China